The Reconstitution of Work Practices Following a Radical Hospital Restructuring
Bibliographic record
Abstract
Through this two-year ethnographic study we report on the merger and integration of two neonatal intensive care units belonging to separate hospitals into a newly built super hospital. Our field study of this transformation process offers analysis regarding the organizing challenges surfaced by the move, the adaptation to a new space with novel material arrangements, and the melding of units previously located in different hospitals. We trace how and why, as a result of sweeping changes in social and material configurations, work practices became less resilient and less performant. From this radical hospital restructuring, we offer insight on how the organizing mechanisms of existing work practices are constituted and how they are reconstituted given novel material, technological and social foundations. We find that practices have to be reconstituted when the sociality and materiality of a site of practice are dramatically altered. We develop how three essential organizing mechanisms (practice orientations, skillful performance and instrumentation configurations) provide coherence and resilience to a practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.011 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".